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Chickenpox—varicella-zoster 

Chickenpox—varicella-zoster
Chapter:
Chickenpox—varicella-zoster
DOI:
10.1093/med/9780198729228.003.0053
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date: 26 June 2019

Chlamydia pneumoniae is an obligate intracellular Gram-negative bacteria that may cause community-acquired pneumonias with a prevalence of 2–19%. First infections are especially common between the ages of 5 and 15 years. There are no characteristic clinical features that distinguish C. pneumoniae from other common respiratory pathogens. Patients may be asymptomatic or mildly to moderately ill with upper and/or lower respiratory tract involvement. Pneumonia is the most important disease, and it usually presents with mild constitutional symptoms, including low-grade fever, malaise, headache, cough, pulmonary rales, and non-exudative pharyngitis. Illness can be prolonged, and cough can persist for 2–6 weeks with a biphasic course. Wheezing is a common clinical manifestation in children; C. pneumoniae has also been associated with exacerbations of chronic asthma. Co-infection of C. pneumoniae with other respiratory pathogens is common. Specific diagnosis is based on isolation of the organism by culture or positive nucleic acid amplification test. The microimmunofluorescence antibody test and immunohistochemistry can also be used as additional tests. Macrolides are the drugs of choice in paediatrics; tetracycline, doxycycline, or quinolones are also effective but can only be administered in older patients. Treatment may need to be continued for several weeks in some patients to reduce the risk of failure or recurrences. Future research should focus on the association between C. pneumoniae and exacerbations of chronic asthma, the role of C. pneumoniae in respiratory viral and bacterial co-infections, and the optimal duration of antimicrobial treatment.

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